Walking Together: My Sons' High School Graduation Was Extra Special - Pulmonary Hypertension News
Walking Together: My Sons' High School Graduation Was Extra Special - Pulmonary Hypertension News |
- Walking Together: My Sons' High School Graduation Was Extra Special - Pulmonary Hypertension News
- Commonly prescribed drugs could increase the risk of dementia, says a new study - Medical Xpress
- Results Support Therapeutic Intra-vascular Ultrasound (TIVUS) for - Pulmonary Hypertension News
| Posted: 24 Jun 2019 07:00 AM PDT My son's pulmonary arterial hypertension (PAH) was idiopathic, which means it developed suddenly with no known cause. He was healthy until he became symptomatic at 6 years old. Before then, we only brought him to the doctor for checkups and the occasional ear infection. He was an early walker who quickly mastered running and decided that was his preferred pace. His daycare providers were concerned that this little toddler was going to hurt himself because he wouldn't slow down. As he grew into a little boy, he took off into sports, playing soccer and T-ball, and taking karate classes. Perhaps it was a slow progression. We weren't looking for any health concerns, so the decline in his energy levels seemed to happen suddenly. We suspected something was wrong when instead of running, he would walk the soccer field with his arms above his head, taking deep breaths. We knew something was amiss when just as he was about to score a goal, he sat down on the field insisting he couldn't go any further. Self-preservation taught him to walk instead of run, and two years later, he was diagnosed with PAH. For the next five years, our lives revolved around making different types of goals for him, such as staying well enough to graduate from the eighth grade, and remaining sufficiently stable to receive a heart and double-lung transplant. A few weeks shy of what would have been the start of his freshman year of high school, my son received his life-saving transplant. While his peers were making new friends and settling into their classes, he was recovering from major surgery. A week after transplant, he became ill with posterior reversible encephalopathy syndrome (PRES), a rare side effect from an antirejection medication that caused chronic migraines and seizures. The cure was switching medications, but the PRES symptoms remained for several months, making it impossible for him to attempt any schoolwork. Five months post-transplant, he started online high school classes. He worked hard to catch up through summer vacation so that by the fall he was walking the halls of a high school for the first time. He managed to complete the year while facing new medical challenges that required several hospital stays and clinic visits. His lungs began to develop bronchiolitis obliterans (scarring and inflammation), which can lead to chronic rejection. He was started on an aggressive treatment called extracorporeal photopheresis (ECP). Each hospital treatment took at least four hours, and this continued for several months. When you add monthly intravenous immunoglobulin and basiliximab infusions, high doses of prednisone that caused migraines and body aches, as well as antibiotics that made him nauseous, it was incredible that he attended school at all. The good news was that the ECP worked, and his pulmonary function tests showed improvement. However, after a year of stress trying to stay caught up academically, and not knowing what other medical challenges he might later face, my son walked out on the last day of his sophomore year and returned to online education. His was a wise decision because he faced subsequent unforeseen challenges with kidney disease and high blood pressure. It took a lot of determination and self-discipline — including sacrificing two more summers to additional classes, plus an extra year of high school — to reach his goal. But he did it. On June 15, 2019, he graduated from high school alongside his brother, who is one year younger. It was both appropriate and emotional to see the brothers take that walk together. As the sibling of someone who is chronically ill, my youngest has also made sacrifices, faced fears, and struggled to adjust to a life that is different from that of his peers. Both boys were proud of each other as they received their diplomas together. In this fast-paced world, people tend to feel rushed into accomplishing things. What my son has taught me through his pre- and post-transplant experiences is that life should be a walk, not a race. You don't have to keep up with the masses to succeed. If you are always running, then unexpected challenges will feel like hitting a brick wall. Those who walk can see the roadblocks ahead and figure out a better path to avoid them. The journey might be longer, but it will feel more rewarding when you arrive at your destination.  *** Note: Pulmonary Hypertension News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Hypertension News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to pulmonary hypertension.  |
| Commonly prescribed drugs could increase the risk of dementia, says a new study - Medical Xpress Posted: 24 Jun 2019 08:00 AM PDT  The study, carried out by experts from the University of Nottingham and funded by the NIHR School for Primary Care Research, found that there was nearly a 50% increased risk of dementia among patients aged 55 and over who had used strong anticholinergic medication daily for three years or more. Anticholinergic drugs help to contract and relax muscles. They work by blocking acetylcholine, a chemical that transmits messages in the nervous system. Doctors prescribe the drugs to treat a variety of conditions, including chronic obstructive pulmonary disease, bladder conditions, allergies, gastrointestinal disorders and symptoms of Parkinson's disease. These medicines can have short-term side effects, including confusion and memory loss, but it is less certain whether long-term use increases the risk of dementia. The research, published in the JAMA Internal Medicine journal and led by Professor Carol Coupland from the University's Division of Primary Care, looked at the medical records of 58,769 patients with a diagnosis of dementia and 225,574 patients without a diagnosis of dementia, all aged 55 and over and registered with UK GPs contributing data to the QResearch database, between 1 January 2004 and 31 January 2016. The study findings showed increased risks of dementia for anticholinergic drugs overall and specifically for the anticholinergic antidepressants, antipsychotic drugs, antiparkinsons drugs, bladder drugs and epilepsy drugs after accounting for other risk factors for dementia. No increased risks were found for the other types of anticholinergic drug studied such as antihistamines and gastrointestinal drugs. Professor Tom Dening, Head of the Centre for Dementia at the University of Nottingham and a member of the research study team, said: "This study provides further evidence that doctors should be careful when prescribing certain drugs that have anticholinergic properties. However, it's important that patients taking medications of this kind don't just stop them abruptly as this may be much more harmful. If patients have concerns, then they should discuss them with their doctor to consider the pros and cons of the treatment they are receiving." The 58,769 patients with dementia had an average age of 82 and 63% were women. Each dementia case was matched to five control patients of the same age, sex, and general practice. Anticholinergic drug exposure was assessed using prescription information over a complete period of 10 years from 1 to 11 years before diagnosis of dementia or the equivalent dates in control patients, and was compared between the two patient groups. Further analysis looked at prescriptions for anticholinergic drugs up to 20 years before diagnosis of dementia. This is an observational study so no firm conclusions can be drawn about whether these anticholinergic drugs cause dementia, and it is possible that the drugs were being prescribed for very early symptoms of dementia. Professor Coupland said: "Our study adds further evidence of the potential risks associated with strong anticholinergic drugs, particularly antidepressants, bladder antimuscarinic drugs, anti-Parkinson drugs and epilepsy drugs. "The risks of this type of medication should be carefully considered by healthcare professionals alongside the benefits when the drugs are prescribed and alternative treatments should be considered where possible, such as other types of antidepressants or alternative types of treatment for bladder conditions. These findings also highlight the importance of carrying out regular medication reviews. "We found a greater risk for people diagnosed with dementia before the age of 80 which indicates that anticholinergic drugs should be prescribed with caution in middle-aged people as well as in older people." These results, along with those of a similar study published in 2018 help to clarify which types of anticholinergic drug are associated with the highest risks of dementia. In the 1-11 years before the dementia diagnosis date or equivalent in controls, nearly 57% of cases and 51% of controls were prescribed at least one strong anticholinergic drug, with an average of six prescriptions in cases and 4 in controls. The most frequently-prescribed types of drugs were antidepressants, anti-vertigo and bladder antimuscarinic drugs—which are used to treat an overactive bladder. The increased risk associated with these drugs indicates that if the association is causal around 10% of dementia diagnoses could be attributable to anticholinergic drug exposure, which would equate to around 20,000 of the 209,600 new cases of dementia per year in the UK. This is a sizeable proportion and is comparable with other modifiable risk factors for dementia, including 5% for midlife hypertension, 3% for diabetes, 14% for later life smoking and 6.5% for physical inactivity. Provided by University of Nottingham Citation: Commonly prescribed drugs could increase the risk of dementia, says a new study (2019, June 24) retrieved 25 June 2019 from https://medicalxpress.com/news/2019-06-commonly-drugs-dementia.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.  |
| Results Support Therapeutic Intra-vascular Ultrasound (TIVUS) for - Pulmonary Hypertension News Posted: 31 May 2019 12:00 AM PDT New data support the safety and effectiveness of TIVUS (therapeutic intra-vascular ultrasound) for patients with pulmonary arterial hypertension (PAH) on a stable treatment regimen. The data were recently presented at the annual meeting of the European Association of Percutaneous Cardiovascular Interventions (EuroPCR), in Paris. In PAH, small arteries inside the lungs become constricted. This creates resistance, making it harder for the heart to pump blood from the right ventricle to the lungs, resulting in high blood pressure (hypertension) in the pulmonary arteries. Combination therapy with two oral medications to reduce pulmonary vascular resistance is now regarded as the standard of care in PAH. However, many patients continue to have symptoms. The autonomic nervous system, which is responsible for controlling vital functions such as breathing and heart rate, plays an essential role in constricting or dilating blood vessels. The sympathetic system constricts vessels and the parasympathetic system dilates them. Scientists believe vascular constriction in PAH may be a sign of a sympathetic system on overdrive. "A growing body of data suggests that the sympathetic nervous system may play an important role in the pathogenesis of PAH. Decreasing sympathetic activity may help to reduce symptoms and slow disease progression," Alex Rothman, MD, PhD, who presented the TIVUS results at EuroPCR, said in a press release. The TIVUS system is a therapeutic catheter developed by SoniVie (formerly known as Cardiosonic) that is introduced into the pulmonary artery during a right heart catheterization procedure. The catheter produces ultrasound, which selectively ablates the sympathetic nerves that constrict the pulmonary arteries without damaging the vessel walls or adjacent tissues. Rothman presented results on the safety, performance, and initial effectiveness of the TIVUS System at EuroPCR in an oral session, "Percutaneous therapeutic intravascular ultrasound pulmonary artery denervation for the treatment of pulmonary arterial hypertension (TROPHY1): a multicenter, international, open-label trial." TROPHY1 (Treatment Of Pulmonary Hypertension 1; NCT02835950 and NCT02516722) was conducted at eight clinical sites in Europe, Israel, and the United States. It involved 23 Functional Class III PAH patients who were on an established regimen of dual-oral medical therapy. Functional Class III means that patients showed symptoms and marked limitation of activity. TROPHY1 data showed that there were no serious adverse events related to the TIVUS device or procedure. Five months after the procedure, pulmonary vascular resistance decreased by a mean of 17.8% in patients, and the six-minute walk distance increased by 42 meters (the 6-minute walk test measures aerobic capacity and endurance). Daily activity increased with respect to baseline values. A reduction in baseline pulmonary vascular resistance of more than 10% was observed in 70% of the patients, and 40% had a reduction of more than 20%. Improvements in mean pulmonary artery pressure and right atrial pressure were also observed. However, at five-month follow-up, no significant changes were identified in quality of life or in N-terminal pro b-type natriuretic peptide levels (a hormone produced in the heart in response to heart failure or cardiac dysfunction). "The favorable safety and initial efficacy results observed to date in TROPHY1 suggest that TIVUS improves cardiopulmonary function and daily activity in PAH patients. Additional studies of this innovative approach to PAH therapy are warranted, as many patients continue to have symptoms on current treatment options," Rothman said. Chuck Carignan, MD, chief executive officer at SoniVie, said: "The completion of TROPHY1 is an important milestone for the company, and the results provide a solid foundation on which to advance the clinical and regulatory development of the TIVUS System. We expect to initiate a pivotal trial in 2020."  |
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